Individual provider Active NPI

Larry Jay Loewen Jr., D.C

  • Chiropractor
  • Crystal Falls, MI
National Provider Identifier
1609095496
Registry record updated Oct 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301008438 Issued in MI
Practice address
1374 Commercial Ave
Suite 3
Crystal Falls, MI 49920-1085
Phone
(906) 875-3215
Fax
(906) 874-3215
NPI assigned
Apr 24, 2007
Last updated
Oct 27, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301008438 MI Primary
Sports Physician Chiropractor 111NS0005X 2301008438 MI
Occupational Health Chiropractor 111NX0100X 2301008438 MI
Orthopedic Chiropractor 111NX0800X 2301008438 MI
Rehabilitation Chiropractor 111NR0400X 2301008438 MI

Addresses

Primary practice location

1374 Commercial Ave
Suite 3
Crystal Falls, MI 49920-1085

Mailing address

1374 Commercial Ave
Suite 3
Crystal Falls, MI 49920-1085
Phone (906) 875-3215

Other identifiers 1

IdentifierTypeStateIssuer
950D75037OtherMIBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070620000046 MI Practitioner - Chiropractic 7113026915 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1342 US Hwy 2
Crystal Falls, MI 49920-1000
Phone (906) 875-3215

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301008438MIMDSports Physician Chiropractor
4543WIMDPhysician Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256601600000",
    "number": "1609095496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1374 COMMERCIAL AVE",
            "address_2": "SUITE 3",
            "city": "CRYSTAL FALLS",
            "state": "MI",
            "postal_code": "499201085",
            "telephone_number": "906-875-3215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1374 COMMERCIAL AVE",
            "address_2": "SUITE 3",
            "city": "CRYSTAL FALLS",
            "state": "MI",
            "postal_code": "499201085",
            "telephone_number": "906-875-3215",
            "fax_number": "906-874-3215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOEWEN",
        "first_name": "LARRY",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2009-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301008438",
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "MI",
            "license": "2301008438",
            "primary": false
        },
        {
            "code": "111NX0100X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Occupational Health",
            "state": "MI",
            "license": "2301008438",
            "primary": false
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "MI",
            "license": "2301008438",
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "MI",
            "license": "2301008438",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "950D75037",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Falls, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.